Aims To evaluate the technique of eye drop instillation in patients with glaucoma and assess factors associated with a good technique. Methods A cross-sectional observational study of 85 participants using selfadministered topical medication for glaucoma or ocular hypertension. Patients were asked to demonstrate how they normally instil eye drops using a 5-ml bottle of sterile artificial tear solution. The procedure was recorded and assessed by two masked graders. Whether the patient had been previously shown how to instil drops, the number of eye medications used, and self-perceived difficulty of using drops were also recorded. Conclusions Education relating to eye drop instillation technique is significantly associated with a patient's ability to instil drops correctly. The assessment of a patient's ability to instil eye drops correctly should be a routine part of the glaucoma examination.

ImportanceOcular trauma terminology should be periodically updated to enable comprehensive capturing and monitoring of ocular trauma in clinical and research settings.ObjectiveTo update terminology for globe and adnexal trauma.Design, Setting, and ParticipantsA 2-round modified Delphi survey was conducted from January 1 to July 31, 2021, using an expert panel, including 69 ophthalmologists identified through their membership in ophthalmology (globe and adnexal trauma) societies. Consensus was defined as at least 67% expert agreement. A steering committee developed questions after identifying gaps in the current terminology via a targeted literature review. Round 1 sought consensus on existing and newly proposed terminology, and round 2 focused on unresolved questions from round 1. Experts included ophthalmologists who had managed, on average, 52 globe or adnexal trauma cases throughout their careers and/or published a total of 5 or more globe or adnexal trauma–related peer-reviewed articles.Main Outcomes and MeasuresExpert consensus on ocular and adnexal terms.ResultsA total of 69 experts participated in and completed round 1 of the survey. All 69 participants who completed round 1 were asked to complete round 2, and 58 responses were received. Consensus was reached for 18 of 25 questions (72%) in round 1 and 4 of 7 questions (57%) in round 2. Existing Birmingham Eye Trauma Terminology system terminology achieved consensus of 84% (58 of 69 experts) in round 1 and 97% (56 of 58 experts) in round 2. Experts agreed on the need for further refinement of the definition of zones of injury (55 of 69 [80%]), as the zone affected can have a substantial effect on visual and functional outcomes. There was consensus that the mechanism of injury (52 of 69 [75%]) and status of the lacrimal canaliculi (54 of 69 [78%]), nasolacrimal ducts (48 of 69 [69%]), lens (46 of 58 [80%]), retina (42 of 58 [73%]), and central and paracentral cornea (47 of 58 [81%]) be included in the revised terminology.Conclusions and RelevanceThere was consensus (defined as at least 67% expert agreement) on continued use of the existing Birmingham Eye Trauma Terminology system definitions and that additional terms are required to update the current ocular trauma terminology.

The use of salience as a tool to determine which stakeholders matter may lead to the marginalization of some stakeholder groups. As a normative theory, salience is problematic because it uproots stakeholder theory from its moral foundations. As a descriptive theory, its prevalence has found mixed support in literature. In order to overcome these limitations, scholars have recommended grounding stakeholder theory in ethics of care. These recommendations have largely been normative but still lack empirical support. We present the case of Escuela Social Ana Bella to show that, particularly when dealing with marginalized stakeholders, stakeholder theory rooted in ethics of care has considerable explanatory power. We find that firms can engage with fringe stakeholders when the decisions of managers are informed by emotions. We also find that this engagement can have the power to transform the beneficiary stakeholder group to an extent where they may become, paradoxically, salient stakeholders for the firm. JEL CLASSIFICATION: M14

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Industrial radiography (IR) is an important application of radiation in which an ionizing radiation source is used to detect any cracks or hidden flaws within machinery and welding joints. A category-2 radioactive source (if not shielded properly, it can cause serious and potentially terminal health consequences) is used in IR. It can cause severe detrimental effects like burns if not used properly. There have been many IR related accidents worldwide which are also available on the International Atomic Energy Agency (IAEA) website. This case is written on two isolated events that happened in Pakistan within the same company (name changed) engaged in IR services within Pakistan. Alpha Industrial Services Limited’s (AISL) higher management was dealing with a prevailing financial crunch, and the company was struggling to maintain its quality of services and safety at an affordable cost. The leadership of the company made several decisions to manage the financial crisis.